12例金属碎片射入胸部手术处理

对12例胸部金属异物患者术前行胸部X线检查(或同时行胸部CT检查),分别在局麻或全麻下手术治疗。所有患者均顺利取出异物,胸部创口及手术切口甲级愈合,随访4个月,所有患者恢复正常生活。     

晚期鼻咽纤维血管瘤切除术前介入栓塞的临床应用

目的 探讨晚期鼻咽纤维血管瘤（juvenile nasopharyngeal angiofibroma,JNA）术前介入栓塞的临床应用价值。方法 回顾性分析2020年11月至2021年9月复旦大学附属眼耳鼻喉科医院收治的13例晚期鼻咽纤维血管瘤患者的临床资料。所有患者均在肿瘤切除术前行介入栓塞术。分析所有患者的肿瘤供血动脉、介入栓塞并发症、切除术中出血量、肿瘤切除率等情况。结果 所有患者无明显介入栓塞并发症,栓塞当日行肿瘤切除,术后复查肿瘤均得到完全或大部分切除,术中出血量为100～2000 mL,平均877 m L。所有患者术后病理结果均证实为纤维血管瘤或血管纤维瘤。结论 晚期鼻咽纤维血管瘤术前介入栓塞可以减少肿瘤切除术中出血量,提高肿瘤切除率,是一种行之有效的方法。     

门静脉金属内支架置入治疗门静脉海绵样变

目的：探讨经皮肝穿刺和经颈内静脉肝内门体分流术(TIPS)途径门静脉内支架置入治疗门静脉海绵样变(CTPV)的疗效及安全性。方法回顾性分析于本科治疗的8例 CTPV 患者的临床及影像学资料。所有患者均行门静脉金属内支架置入治疗,其中3例经 TIPS 途径放置,5例经经皮肝穿刺途径放置。结果所有患者支架置入均一次性成功,无腹腔内出血等严重并发症发生。术中即刻复查造影显示支架内血流通畅,术后1 d~2周患者腹痛及消化道出血症状均明显减轻或消失。术后所有患者均获得完整随访,随访1个月~3年,1例患者术后1 年复查支架闭塞,再次置入1枚支架后血流通畅,其余患者彩超提示支架内血流通畅,未再发消化道出血或腹痛。结论经皮肝穿刺或经 TIPS 途径门静脉金属内支架置入治疗 CTPV 是一种安全有效方法。     

电离子手术治疗机治疗老年疣60例疗效观察

目的:评价电离子手术治疗机治疗老年疣的临床疗效.方法:回顾性分析2008 - 05～2010 - 01科门诊采用电离子手术治疗机治疗老年疣并随访6个月的60例老年疣患者病例资料.结果:经过1电离子手术治疗后所有患者均或痊愈,每住患者均有不同程度的疼痛,持续时间短,所有患者均无局部感染情况出现.随访结束时,除2例患者有轻微的凹陷性痕形成外,余无明显不良反应.结论:电离子手术治疗机治疗老年疣是一种操作简单、安全、有效的治疗方法.     

探讨介入治疗对晚期胰腺癌的疗效

目的评价介入治疗对晚期胰腺癌的疗效。方法收集2005年4月起在本科做介入治疗的33例晚期胰腺癌患者的资料。所有患者均为不能手术的晚期胰腺癌患者,均接受1次或多次介入治疗。重复治疗者间隔时间为6周,所有患者均接受腹腔动脉和肠系膜上动脉化疗灌注,给药比例为2∶1,术后未发现严重并发症。结果患者术后自觉疼痛、腹胀等不适症状明显减轻甚至消失,有效缓解率为91%(30/33)。所有患者术后CT复查显示癌肿均有不同程度缩小,缩小≥90%者占78.8%(26/33)。介入治疗后生存期平均为13个月,目前仍有26例存活,最长者已存活21个月。结论介入治疗可作为晚期胰腺癌不能手术者的首选疗法。     

选择性支气管动脉插管灌注化学药物治疗中晚期肺癌

本文收集了经支气管动脉介入治疗中晚期患者192例对192例均行支气管动脉造影术及术后CT或X线平片复查照,报告如下。1材料与方法1.1一般资料收集我院1998-04—2006-03中晚期肺癌192例,均为不能手术或高龄不愿接受手术治疗的住院患者。所有病例均有X线胸片及CT、MR检查资料。均经     

颈部恶性淋巴结病变CT灌注成像与微血管密度的研究

目的 探讨CT灌注成像(CTP)对颈部恶性淋巴结病变鉴别诊断的价值及各灌注参数与微血管密度(MVD)的相关性.方法 回顾性分析未经治疗的颈部恶性淋巴结病变患者78例,包括23例淋巴瘤及55例淋巴结转移瘤,其中38例鳞状细胞癌淋巴结转移,17例甲状腺乳头状癌淋巴结转移.所有淋巴结均经手术或穿刺活检病理证实.所有患者术前均...     

双标记延迟时间3D ASL对脑血管狭窄灌注代偿的评估价值

目的 探讨磁共振三维动脉自旋标记(three-dimensional arterial spin labeling,3D ASL)采用双标记延迟时间(postlabeling delays,PLD)评估脑血管狭窄或闭塞后侧枝循环灌注代偿的价值.方法 以一侧颅内供血动脉严重狭窄或闭塞的患者为观察对象,所有患者均行DWI、...     

脑静脉窦血栓形成的介入治疗

目的 研究血管内介入治疗颅内静脉窦血栓形成的疗效和安全性.方法 对10例临床抗凝治疗无效的颅内静脉窦血栓形成患者行血管内介入治疗,全部患者均接受经静脉插管接触性溶栓联合机械性碎栓治疗,其中4例在接受经静脉途径溶栓后又接受了经动脉溶栓.术后继续抗凝治疗6个月,随访12～29个月,平均21个月.结果 8例患者的临床症状和体征得到缓解或部分缓解,其中6例头痛消失,2例存在轻度头痛.1例症状无明显改善,1例病稃较长的患者残留语言功能障碍.所有患者腰椎穿刺脑脊液压力均恢复正常,未再发生血栓形成和新的神经功能症状.所有患者术中和术后均未发生与操作相关的颅内或全身出血并发症.结论 血管内介入治疗颅内静脉窦血栓是安全、有效的治疗手段.     

经皮血管内激光消融治疗下肢静脉曲张的初步结果观察

目的 :探讨经皮血管内激光消融 (PELA)治疗下肢静脉曲张的初步效果和安全性。方法 :对 16例 2 2条下肢静脉曲张的患者行PELA ,所有患者均有明显的浅静脉曲张 ,同时伴活动后下肢酸胀、疼痛和乏力 ,8例伴肿胀或色素沉着。主要设备为英国DIOMED半导体激光治疗仪。结果 :2 2条患肢经PELA处理即刻静脉造影见大隐静脉主干均闭塞 ,血流中断。 16例患者随访 3～ 12个月 ,原肉眼可见的曲张浅静脉均消失 ,患者不再伴有活动后酸胀、疼痛、乏力或水肿等表现。所有病例无并发症发生。结论 :PELA治疗下肢静脉曲张简单、安全 ,初步结果令人满意。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.